title: Cemented versus cementless endoprostheses for lower limb salvage surgery.
abstract: OBJECTIVE
  To determine the survival and failures of cemented vs cementless endoprostheses.
  
  
  METHODS
  We retrospectively studied 232 patients treated with lower limb salvage surgery and reconstruction using cementless and cemented endoprostheses from 2002 to 2007. We compared survival and failures of the endoprostheses regarding age, gender, body mass index (BMI), diagnosis, site of reconstruction, radiation therapy, chemotherapy, and stem fixation.
  
  
  RESULTS
  The mean patient follow-up was 28 months (median 24; range 12-84). The overall survival of cemented and cementless endoprostheses at 60 months was 64 and 78%, respectively (p=0.0078). Survival at 60 months of cemented and cementless endoprostheses to infection was 68 and 82%, respectively (p=0.0248). Survival of cemented and cementless endoprostheses to aseptic loosening at 60 months was 94 and 96%, respectively (p=0.1493). The only significant univariate and multivariate predictor of survival was the cementless type of stem fixation.
  
  
  CONCLUSIONS
  Cementless endoprostheses have higher overall survival and survival to infection compared to cemented endoprostheses. Survival to aseptic loosening is not different. Stem fixation is the only significant variable for survival.
authors.affiliation: Department of Orthopedics, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pala
authors.forename: A F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: A
authors.initials: A
authors.lastname: Angelini
authors.forename: E R
authors.initials: ER
authors.lastname: Henderson
authors.forename: G
authors.initials: G
authors.lastname: Douglas Letson
authors.forename: P
authors.initials: P
authors.lastname: Ruggieri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D002484:Cementation / Q000009:adverse effects; D002648:Child; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis / Q000009:adverse effects; D023821:Limb Salvage; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements